Unilatelaral iris plateau syndrome after the use of ecstasy

Abstract

Courmon street name for 3,4-Methylenedioxymethamphetamine (MDMA) is ecstasy. This widely abused "recreational" drug causes both an increased release of monoamine neurotransmitters, including serotonine and dopamine, and an increased reuptake inhibition of serotonin. As a consequence, mydriasis and increased intraocular pressure (IOP) in predisposed patients occur. We present herein a rare case of acute increased IOP after use of ecstasy. A female patient, aged 38 years, visited doctor complaing of a decreased vision acuity and severe pain in the left eye and in the left part of the head. The initial treatment was urgent antiglaucomatous therapy followed by withdrawal of subjective problems of the patient and improvement of objective finding. History taking procedure revaled that just before the onset of the pain the patient had used ecstasy and had had similar "experience" 6 years ago after cocaine snorting. She had not been to a doctor although she had experienced sporadic migrenous pain. Previous medical records excavation of revealed optic disk (cup-to-dise C/D=06), Bjerum arcuate scotoma and iris plateau with narrow chamber angle (Scheie II-III) so the diagnosis was a rare unilateral iris plateau syndrome of the left eye. Although the patient was given some pieces of information about the dangerous and possible deadly consequences of psychoactive substanace abuse, she has not continue the treatment. Ecstasy abuse might cause a complete loss of vision, thus medicametous and surgical treatment are abligatory.